Mark Cavendish's Tour de France could be over after a dramatic fall during a bunch sprint in Vittel at the end of stage four.

Frenchman Arnaud Demare came out on top of the carnage that saw Cavendish attempt to make a move on the inside, only to be shunted into the barrier after a nudge from world road race champion Peter Sagan in the final 150 metres.

The dramatic moment can be watched in the above video.

Sagan was later disqualified from the race.

Peter Sagan's elbow appears to extend (Image: EPA/ROBERT GHEMENT)

Mark Cavendish appears to be pushed into the barriers (Image: itvcycling/Twitter)

Manxman Cavendish indicated his Tour may be finished after he injured the same shoulder he hurt in the 2014 Tour - when he crashed in Harrogate.

"Injury-wise I'm going to go and get it checked out. I definitely need stitches in this finger, it's bleeding a lot," he said.

Mark Cavendish has been rushed to hospital for an x-ray (Image: REUTERS/Benoit Tessier)

"And the shoulder, there's something to do with that previous shoulder that I did in Harrogate - it's just sat backwards. I don't know if I've snapped the fake ligament in or what - I'm going to go and get it looked at.